ALCOHOL/EUCALYPTOL/MENTHOL/ME SALICYLATE/THYMOL MOUTHWASH (10186)    VA PRODUCT (50.68)

Name Value
NAME ALCOHOL/EUCALYPTOL/MENTHOL/ME SALICYLATE/THYMOL MOUTHWASH
VA GENERIC NAME ALCOHOL/EUCALYPTOL/MENTHOL/METHYL SALICYLATE/THYMOL
DOSAGE FORM LIQUID
ACTIVE INGREDIENTS
CS FEDERAL SCHEDULE Unscheduled
INACTIVATION DATE 2004-11-18 00:00:00
DSS NUMBER 2
NATIONAL FORMULARY NAME ALCOHOL/EUCALYPTOL/MENTHOL/METHYL SALICYLATE/THYMOL LIQUID
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   2
    COPAY EFFECTIVE DATE:   2017-02-27 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
TRANSMIT TO CMOP NO
MASTER ENTRY FOR VUID NO
VUID 4010562
EFFECTIVE DATE/TIME
  • 2005-03-10 00:00:00
    STATUS:   ACTIVE
  • 2005-12-08 00:00:00
    STATUS:   ACTIVE
  • 2007-09-28 00:00:00
    STATUS:   INACTIVE
  • 2004-11-18 00:00:00
    STATUS:   INACTIVE